Provider Demographics
NPI:1205943099
Name:SUNDLOV, CHERYL N (PA-C,MPH)
Entity type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:N
Last Name:SUNDLOV
Suffix:
Gender:F
Credentials:PA-C,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3038 ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4520
Mailing Address - Country:US
Mailing Address - Phone:407-310-8380
Mailing Address - Fax:
Practice Address - Street 1:12600 SW 120TH ST
Practice Address - Street 2:SUITE 113
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-9066
Practice Address - Country:US
Practice Address - Phone:305-971-1210
Practice Address - Fax:305-971-7710
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052242363AM0700X
FLPA 9102138363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical